In this week’s article I will be discussing a recent query that I received from a woman suffering from chronic neck pain coupled with pins & needles into the hand fingers. Due to the ferocity of the pain she was not able to work as a Hairdresser. A lot of people with neck & hand will be able to identify with the symptoms and my diagnosis will help understand why these symptoms have occurred.
Her common symptoms are as follows;
Neck pain and stiffness throughout the day
Achy pain and heaviness in both her arms
Weakness in her hand grip with an ability to suddenly drop objects
Pins & Needles into her thumb and accompanying index and middle finger when working with her hands such as combing hair or driving
Awoken at night with numbness into the hand
So what could be the cause of this hand pain?
Compression of the median nerve is causing the numbness, pins & needles and weakness into the thumb, index finger and middle finger. The median nerve stems from the cervical spine of the neck and controls movement and sensation into the hand and fingers. So how can it get compressed? It can be compressed within a) the Carpal Tunnel bone channel of the wrist, b) median nerve root compression by a locked facet joint, c) Disc impingement on nerve root, d) Tight scalene Neck muscles. e) Within the forearm by restrictive Pronator Teres Muscles.
What is causing the neck pain?
Possible excessive mobility at the C5 & C6 vertebrae blocks of the cervical spine coupled with excessively tight scalene neck muscles. In addition the problem may lay with an Inflamed and restricted facet joint of the cervical spine.
Treatment & Management
The first goal is an examination to correctly diagnose where the median nerve is being impinged. Indeed several of the aforementioned conditions may exist together and this is termed “Double Crush syndrome”. So what needs to be treated? Well the cervical spine restrictions needs to mobilized by gentle graded techniques in order to improve movement while at the same time excessive vertebral mobility needs to be reduced. The tightened scalene neck muscles need to be released by gentle stretching treatment techniques. This can slowly achieve the objective of releasing median nerve impingement. With regard to wrist and forearm impingement, phased Nerve gliding coupled with forearm muscle release treatment will assist in freeing the underlying restricted median nerve.
Think of the median nerve as a Water Hose Pipe with several knots, when the knots are released then the water will flow at full strength; the same analogy can be applied to the medial nerve!
Next week, I will write about further queries concerning neck pain.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 086 3275 753
Email your queries to: firstname.lastname@example.org
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